State medical board drops wrong-site complaints against South Florida surgeon

An internationally known West Palm Beach orthopedic surgeon has been cleared of any alleged wrongdoing in two administrative complaints involving pediatric patients who had metal plates implanted in the wrong parts of their bodies.

The Florida Board of Medicine said allegations that Dr. Dror Paley performed or furthered wrong-site surgeries were groundless because he did not do the procedures being investigated. Three members of the board's Probable Cause Panel last week ruled unanimously to drop Paley's cases, filed by the Florida Department of Health in 2014 and 2015.He potentially faced penalties ranging from a reprimand to revocation of his medical license.

Advertisement

"I think when we pointed out that you can't pursue disciplinary action against a doctor regarding a procedure that was performed by someone else, [the panel] understood why the case shouldn't be pursued," said Alex Barker, Paley's attorney.

While Paley planned and supervised the two cases, Dr. Matthew Harris was the one who placed an implant in the wrong ankle during one surgery, and on the wrong side of the leg in another, according to Florida Department of Health investigators' reports.

Harris already had been investigated and cleared in connection to the same two incidents. One complaint was dismissed by the Probable Cause Panel in March 2014, the other in June 2015, according to Florida Board of Medicine officials. Panel members who cleared Harris cited his youth and inexperience, and his descriptions of confusion and chaos during the operations.

The two incidents happened within a little over three months of each other between 2012 and 2013. Both errors were corrected immediately, and the patients suffered no lasting harm, according to Florida Department of Health investigators' reports. Paley on Tuesday said he was "pleased to be exonerated of these allegations. I never have performed a wrong-site surgery and, hopefully, I never will."

The Paley Orthopedic and Spine Institute, on the grounds of St. Mary's Medical Center in West Palm Beach, performs about 1,500 orthopedic procedures annually on adults and children who come from around the world, Paley said. It specializes in limb lengthening and correcting deformities, most caused by birth defects or injuries.

According to documents submitted to the panel last year, Paley has performed more than 20,000 surgical procedures in his 30-plus year career.

Harris, who did a fellowship at the institute, was properly licensed and credentialed during the two incidents. He left the practice in 2013, and is the founder and director of the Joint Preservation and Limb Reconstruction Center in Jupiter.

Rose Marie Antonacci-Pollock, Harris' attorney, said the doctor has "been investigated and was exonerated" regarding the two incidents and declined to comment.

"The Paley Institute performs groundbreaking and life changing surgery on children from around the world, and these [investigated] cases were no exception, despite what occurred," Antonacci-Pollock said in a written statement.

The incidents involved two young boys identified only by initials in state documents. Both still are institute patients, Paley said.

Advertisement

They were surgically implanted with small metal 8-plates. Paley said the surgeries were routine and relatively minor.

In September 2012, R.S. had an implant installed in his left instead of right ankle, which was noticed by his mother in the recovery room, who asked why the wrong ankle was bandaged, state health department investigators said in their report.

Then in January 2013, F.W. still was in the operating room when Harris realized he had placed the plate on the wrong side of the leg, according to the health department report.

Paley said that, as with all institute cases, he and his team held extensive preoperative planning conferences, reviewing PowerPoint presentations, x-rays and procedures a week before the surgeries. He said he also gave instructions just before operating.

In the 2013 health department report about R.S.'s case, investigators said Harris told them he had spoken with Paley about the "communication breakdown" and the misunderstandings about the instructions. Harris told investigators he "greatly regrets" the incident, according to the report.

Although Paley said the institute already was following state safety regulations, he "tightened up" procedures following the two incidents, particularly regarding 8-plate insertions.

"Our reputation is very important to us," said Paley.

The panel also found no evidence that the way Paley structured his large practice contributed to the incidents. The health department complaints expressed concerns that the institute was doing multiple surgical procedures simultaneously in different operating rooms.

Both incidents involved two surgeons and two patients who were being operated on simultaneously but in separate rooms, according to documents.

A few months before the Probable Cause Panel made its decision on Paley, the U.S. Senate Finance Committee, which oversees Medicare and Medicaid, conducted a review of overlapping surgeries throughout 20 hospital systems nationwide. The committee looked at safeguards and whether people were informed they would be sharing a surgeon with another patient.

Florida health and medical regulationsdo not prohibit a surgeon from performing multiple surgeries at the same time on different patients.

Zachary Bell, the health department's assistant general counsel, sent a letter to the panel in January, suggesting the complaints against Paley be dismissed as the doctor's attorney had provided "compelling, additional information which suggests that neither [Paley] nor his surgical practice environment contributed to the wrong-site procedure."